The once and future King

South L.A. desperately needs health services. What's ahead now that King-Harbor is closed?

September 09, 2007|Robert K. Ross | Robert K. Ross, a doctor, is president and chief executive of the California Endowment, a private health foundation created in 1996 to expand access to affordable, quality healthcare.

The county's decision to close Martin Luther King Jr.-Harbor Hospital is a sad one that will deal a severe blow to the health of the people of South Los Angeles.

It is particularly distressing because the establishment of a comprehensive teaching hospital in the heart of this community in 1972 represented such a pivotal change and such a hopeful moment. The decision to open the facility in Willowbrook, just south of Watts, was aimed at correcting the health injustices cited by the McCone Commission, which in the wake of the 1965 L.A. riots had issued the following statement as part of its findings:

"Statistics indicate that health conditions of the residents of South-Central Los Angeles are relatively poor and facilities to provide medical care are insufficient. . . . Life expectancies are considerably shorter . . . [and] the number of doctors in the southeastern part of Los Angeles is grossly inadequate as compared to other parts of the city. . . . The hospitals readily accessible to the citizens in southeastern Los Angeles are also grossly inadequate in quality and in numbers of beds."

Yet today, more than four decades later, it is both regrettable and shameful that the commission's findings still describe the conditions of South Los Angeles.

Based on virtually every health indicator, the South Los Angeles area remains among the most disadvantaged and underserved communities in the nation. Diabetes rates are 44% higher than elsewhere in the county, hypertension rates are 24% higher, HIV/AIDS rates are 38% higher, and asthma rates are 11% higher. In South L.A., more people die of lung cancer, stroke, diabetes and heart disease than in any other place in L.A. County, according to government figures.

A whole generation of young people is being lost in South L.A. -- the infant mortality rate is 20% higher than the overall figure for the county, and for African Americans in South L.A., it is more than double the countywide figure. At the same time, homicide rates among South L.A. adolescents and young adults (ages 15 to 34) are off the charts when compared with the countywide rate -- an alarming 200% higher.

And just to finish the picture, South L.A. has the highest percentage of children and the second-highest percentage of adults (after Metro L.A.) without health insurance in the county.

In a fair world, the community with the most dire health conditions in the county would have the strongest and most comprehensive health delivery system, right? But not in this world. Several months ago, the California Endowment, the private nonprofit foundation that I run, commissioned a respected consulting firm to study the health needs and healthcare capacity of South Los Angeles. The findings paint an alarming picture of a broken healthcare system that failed to meet the needs of residents even before the closure of King-Harbor Hospital. The findings include:

* Emergency and trauma services: There is a high demand for trauma and emergency services in South Los Angeles, where the population faces critical chronic-disease conditions and is prone to violent injuries. Yet South L.A. has had the lowest number of emergency-room treatment stations per person than any other part of L.A. County. As any doctor will tell you, minutes count when dealing with trauma care and can literally mean the difference between life and death. However, with the closure of the hospital, South L.A. patients must now travel longer and farther to receive care. For uninsured patients, the closest subsidized, county-run hospitals to King-Harbor are eight and 11 miles away.

* Inpatient services: According to our analysis, South Los Angeles needs an estimated 2,100 hospital beds. Yet the number of beds after the closure of King-Harbor is about 700. In terms of hospital beds per 1,000 residents, South L.A. ranks among the lowest urban regions in the country. Nationally, the average is about 3 beds per 1,000 residents; California has an average of 2; West Los Angeles has about 4, and South Los Angeles has about 1 bed per 1,000 residents. The result: further strain on overcrowded emergency rooms (because patients are forced to stay in the ER when no beds are available) and negative effects to quality of care.